• This Disposition Table is a history of UT Arlington Business Affairs, Human Resources, and Campus Operations forms and exhibits.
  • The date is an estimate of when the events shown in the Status column occurred.
  • Some form numbers were reused by re-issuing the number of a discontinued form to new one created.

By default, columns are sorted by form number. You may change the sort by clicking on the table headings.

For questions or corrections, contact UT Arlington Net Solutions at netsolutions@uta.edu.

Index
Title
Owner
Status
Date
1-1 Departmental Payroll Voucher Payroll Services Published 01/01/1999
1-1 Budget Request for Fiscal Year Payroll Services Discontinued 11/01/1993
1-2 Check Distribution & Change of Address Payroll/Accounting Published 01/01/1999
1-2 Fiscal Year 1993 Budget Planning Justifications Forms Payroll/Accounting Discontinued 11/01/1993
1-3 Earnings Statement Payroll Services Discontinued 09/24/2008
1-3 Annual Income Budget Projections Payroll Services Discontinued 11/01/1993
1-3A Annual Budget Request for Student Service Fee Allocations Payroll Services Discontinued 11/01/1993
1-4 W-5 Earned Income Credit Advance Pay Certificate Payroll/IRS Discontinued 01/01/2009
1-4 W-5 Earned Income Credit Advance Pay Certificate Payroll Services Discontinued 03/23/2006
1-4 1998 Form W-5 Payroll/IRS Discontinued 01/01/1999
1-4 Monthly Budget Listing Payroll/IRS Discontinued 11/01/1993
1-5 UTA Time Card Payroll Services Discontinued 01/01/1999
1-5 Request for Budget Change Payroll Services Discontinued 11/01/1993
1-6 Departmental Vacation/Holiday Payroll Voucher Payroll Services Published 01/01/1999
1-6 Summer Session Budget Planning Document Payroll Services Discontinued 11/01/1993
1-6.1 Blanket Request Reappointments Payroll Services Discontinued 11/01/1993
1-7 Salary Spread Request Payroll Services Published 01/01/1999
1-8B Authorization for Professional Services (Less than $600) Payroll Services Published 03/07/2011
1-8A Authorization for Professional Services Payroll/Accounting Published 03/03/2011
1-8C Statement for Foreign National Honoraria Recipients Payroll Services Published 02/23/2011
1-8 Authorization for Professional Services with Instructions Payroll/Accounting Discontinued 02/22/2011
1-8A Authorization for Professional Services Payroll/Accounting Published 02/22/2011
1-8 Authorization for Professional Services Payroll/Accounting Published 01/01/1999
1-9 Payee Information Form Payroll/Accounting Published 01/01/1999
1-10 Visa Waiver Countries Payroll Services Discontinued 09/24/2008
1-11 W-7 Application for IRS Individual Taxpayer Identification Number Payroll Services Discontinued 09/30/2008
1-12 Countries with Tax Treaties Payroll Services Discontinued 09/24/2008
1-13 IRS 8233 Form Payroll Services Discontinued 09/24/2008
1-14 Payment Request Form - Nonresident Alien Employees/Students Payroll Services Discontinued 09/24/2008
1-17 GLACIER Password - Nonresident Alien Tax Software Payroll Services Discontinued 09/06/2007
1-18 Request for Taxpayer Identification Number and Certificaiton Payroll Services Published 06/07/2005
1-19 W-4 Employee's Withholding Allowance Certificate Payroll/IRS Published 03/23/2006
1-19 W-4 Employees Withholding Allowance Certificate Payroll/IRS Published 11/30/1999
1-20 W-9 Request for Taxpayer Identification Number and Certification Payroll Services Discontinued 09/30/2008
1-21 SS-5 Application for Social Security Card (Original/Replacement/Name Change) Payroll Services Discontinued 09/30/2008
1-22 TRS Web Site Password Authorization Payroll Services Discontinued 09/30/2008
2-1 Account Profile and Request for New Account Accounting Services Published 10/01/1991
2-2 Custodian and Working Fund Authorization Accounting Services Published 10/01/2004
2-2 Departmental Appropriation Ledger Accounting Services Discontinued 10/01/1991
2-3 Official Occasion Expense Form Accounting Services Discontinued 09/20/2007
2-3 Inter-Department Transfer Form Accounting Services Discontinued 11/15/1984
2-4 Check Distribution and Change of Address Accounting Services Discontinued 05/06/2008
2-4 Request for Student Organization University Account Accounting Services Discontinued 10/01/1991
2-5 Texas Sales and Use Tax Exemption Certification Accounting Services Published 11/16/2004
2-5 Gift Advice Accounting Services Discontinued 10/01/1991
2-6 Payment Approval Voucher Accounting Services Published 12/08/2004
2-6 Supplies Inventory Accounting Services Discontinued 10/01/1991
2-7 Departmental Deposit Accounting Services Published 12/08/2004
2-7 Summary - Inventory of Supplies and Materials for Resale Accounting Services Discontinued 10/01/1991
2-8 Restrictive Payee Stamp Accounting Services Published 12/08/2004
2-8 Request to Purchase - Grants Only Accounting Services Discontinued 10/01/1991
2-9 Restrictive Endorsement Stamp Accounting Services Published 12/08/2004
2-9 Payment Approval Voucher - Grants Only Accounting Services Discontinued 10/01/1991
2-10 Daily Check Log Accounting Services Published 12/08/2004
2-10 Departmental Transfer - Grants Only Accounting Services Discontinued 11/15/1984
2-11 Cash Receipt Accounting Services Published 12/08/2004
2-11 Personnel Activity Report Accounting Services Discontinued 10/01/1991
2-12 Statement of Accounts Reconciliation & Acknowledgement Accounting Services Published 12/08/2004
2-12 Payment Approval Voucher (Instructions and Form) Accounting Services Discontinued 08/31/1993
2-13 Direct Deposit Form for Students Accounting/Bursar Published 11/08/2005
2-13 Request for Governor's Approval for State Employees Traveling to Foreign Countries Accounting/Bursar Discontinued 08/31/1989
2-14 Custodian & Working Fund Authorization Discontinued 10/01/1991
2-15 Restrictive Payee Stamp Discontinued 11/01/1993
2-16 Restrictive Endorsement Stamp Discontinued 11/01/1993
2-17 Copy of a Check Discontinued 11/01/1993
2-18 Official Restrictive Endorsement Stamp Discontinued 11/01/1993
2-19 Texas Driver's License Discontinued 10/01/1991
2-20 Student and Faculty/Staff Identification Cards Discontinued 10/01/1991
2-21 Daily Check Log Discontinued 11/15/1984
2-22 Administrative Summons Discontinued 08/31/1986
2-23 Tuition Adjustment Form Discontinued 11/01/1993
2-24 Department Deposit Slip Discontinued 08/31/1990
2-25 Student Organization Payment Approval Voucher Discontinued 10/01/1991
2-26 Justification and Pro Forma Budget Student Financial Services Published 06/18/2007
2-30 Account Authorization Request Form & Instructions DEFINE Published 03/07/2005
2-31 Dean-VP Routing Form & Instructions DEFINE Published 03/07/2005
2-32 *DEFINE User Setup & Instructions (Individual) DEFINE Published 03/07/2005
2-33 Department Office Setup & Instructions (Entire Department) DEFINE Discontinued 03/19/2008
2-34 Electronic Signature Authorization Request & Instructions DEFINE Published 03/07/2005
2-44 Certificate of Physical Inventory of Equipment Asset Management Discontinued 10/01/1991
2-45 Inventory Transaction Form Asset Management Published 10/01/1991
2-46 Equipment Purchase Notice Asset Management Discontinued 10/01/1991
2-47 Removal of Equipment from University Campus Asset Management Published 10/01/1991
2-48 Central Receiving Work Request Form Asset Management Published 12/10/2004
2-48 UTA Building Abbreviations Asset Management Discontinued 10/01/1991
2-49 Asset Information Form Asset Management Published 11/16/2004
2-49 Tips on Taking Annual Inventory Asset Management Discontinued 10/01/1991
2-50 Document Destruction Request Form Asset Management Published 06/15/2007
2-50 Inventory of Supplies and Materials for Resale Asset Management Discontinued 10/01/1991
2-51 Daily Report of Use of State-Owned Motor Vehicle Asset Management Discontinued 10/01/1991
2-60 Application for Nurse Faculty Exemption Student Financial Services Published 03/08/2006
2-61 Application for Preceptor Exemption Student Financial Services Published 03/08/2006
2-62 Nurse Faculty Loan Form Student Financial Services Published 12/22/2004
2-63 Perkins Loan Repayment Form Student Financial Services Published 12/22/2004
2-64 Post Census Tuition Adjustment Request Discontinued 05/06/2008
2-65 Application for Tuition Exemption per TEC 54.208 Peace Officer Enrolled in Criminal Justice Course/s Student Financial Services Published 08/04/2011
2-90 Check Distribution & Change of Address Discontinued 05/06/2008
2-91 Request for Travel Authorization Travel Published 12/08/2004
2-92 Travel Voucher Travel Published 12/08/2004
2-93 Travel Advance Voucher Travel Published 12/08/2004
2-94 Texas Sales and Use Tax Exemption Certification Travel Published 07/06/2009
2-94 Texas Sales and Use Tax Exemption Certification Travel Published 12/08/2004
2-95 Texas Hotel Occupancy Tax Exemption Certificate Travel Published 12/08/2004
2-96 Metroplex Mileage Detailed Report Travel Published 12/08/2004
2-97 Travel Voucher Cover Sheet for Multiple Accts Travel Published 12/08/2004
2-98 Official Occasion Expense Form Travel Published 12/08/2004
2-99 Official Occasions-Entertainment Exp (Memo) Travel Discontinued 11/26/2011
2-99 Official Occasions-Entertainment Exp (Memo) Travel Published 08/20/1996
2-100 Travel Voucher Cover Sheet Travel Published 12/08/2004
2-101 JPMorgan Chase Travel Cardholder Acct Travel Discontinued 10/03/2011
2-101 JPMorgan Chase Travel Cardholder Acct Travel Published 12/08/2004
2-103A Traveler Profile - Carlson Wagonlit Travel Published 07/20/2011
2-103B Traveler Profile - Corporate Travel Planners Travel Published 07/20/2011
2-103 Traveler Profile Travel Discontinued 07/20/2011
2-103 Traveler Profile Travel Published 03/18/2010
2-245 Release of All Claims Discontinued 10/01/1991
3-1 Employee Requisition Form Human Resources Discontinued 11/01/1993
3-2 Position Audit Questionnaire Human Resources Discontinued 11/01/1993
3-3 Personnel Action Form Human Resources Published 03/30/2005
3-3 Personnel Transaction Form ( PO-1 ) Human Resources Discontinued 11/01/1993
3-4 Recruitment Summary for Classified Positions Human Resources Discontinued 11/01/1993
3-5 Record of FLSA (Overtime) Compensation Time Earned and Taken Human Resources Published 11/11/2004
3-5 Personnel Appointment Summary Form Human Resources Discontinued 11/01/1993
3-6 Immigration Reform and Control Act of 1986 Required Documents Human Resources Discontinued 11/01/1993
3-7 Form I-9, Employment Eligibility Verification Human Resources Published 02/02/2009
3-7 Employment Eligibility Verification ( Form I-9 ) Human Resources Published 12/06/2004
3-8 Notice of Voluntary Service Human Resources Published 03/30/2005
3-8 Personnel Termination Form ( PO-2 ) Human Resources Discontinued 11/01/1993
3-9 Criminal Background Check Human Resources Published 11/10/2004
3-9 Employer's First Report of Injury or Illness ( TWCC-1, 2-91 ) Human Resources Discontinued 11/01/1993
3-10 Supplemental Report of Injury ( TWCC-6, 7-93) Human Resources Discontinued 11/01/1993
3-11A Employer's Wage Statement ( TWCC Form 3 ) Human Resources Discontinued 11/01/1993
3-11 Request for Paid Leave Due to On-The-Job Injury (WCI Form 23) Human Resources Discontinued 11/01/1993
3-12 Performance Review Form Human Resources Discontinued 03/01/2009
3-12 Performance Review Form Human Resources Published 09/15/1987
3-13 Employee Separation Process Human Resources Discontinued 12/21/2011
3-13 Employee Separation Process Human Resources Discontinued 09/02/2010
3-13 Employee Separation Form Human Resources Published 08/31/1991
3-14A Grievance Appeal Form Human Resources Discontinued 11/10/2010
3-14 Employee Grievance Form Human Resources Discontinued 11/10/2010
3-14 Employee Grievance Human Resources Published 08/31/1990
3-14A Employee Grievance Appeal Human Resources Published 08/31/1990
3-15 Appeal of Disciplinary Action Human Resources Published 08/31/1990
3-15A Appeal of Disciplinary Action Continuation Human Resources Published 08/31/1990
3-16A Employee Clearance Form - Electronic Notification (PC Version) Human Resources Discontinued 03/10/2011
3-16B Employee Clearance Form - Electronic Notification (Mac Version) Human Resources Discontinued 03/10/2011
3-16 Employee Clearance Form - Electronic Notification Human Resources Published 12/06/2004
3-16A Employee Clearance Form - Electronic Notification (PC Version) Human Resources Published 12/06/2004
3-16B Employee Clearance Form - Electronic Notification (Mac Version) Human Resources Published 12/06/2004
3-16 Employee Check-Out Procedure Human Resources Discontinued 09/15/1987
3-17 Sick Leave Pool Contribution Human Resources Discontinued 11/01/1993
3-18A Statement of Attending Physician Human Resources Discontinued 11/01/1993
3-18 Sick Leave Pool Application Human Resources Published 08/31/1992
3-19 Outside Employment Human Resources Published 11/04/2009
3-19 Outside Employment Human Resources Published 03/30/2005
3-20 Driving Record Release Human Resources Discontinued 11/01/1993
3-21 Authorized Drivers Human Resources Discontinued 11/01/1993
3-22 Driver History Human Resources Discontinued 11/01/1993
3-23 Family Medical Leave Application Human Resources Published 11/01/1993
3-23 Affidavit of Dependency Tuition Adjustment Qualification Human Resources Discontinued 11/01/1993
3-24 Certification of Physician or Practitioner Human Resources Discontinued 11/01/1993
3-25 Your Rights under the Family & Medical Leave Act of 1993 Human Resources Discontinued 11/01/1993
3-27A New Employee Paperwork Human Resources Published 07/17/2007
3-27B Instructions for Employee Packet Human Resources Published 07/17/2007
3-28 Employee Insurance Enrollment Application Human Resources Published 07/10/2007
3-29 Retiree Insurance Enrollment Application Human Resources Discontinued 08/13/2010
3-29 Retiree Insurance Enrollment Application Human Resources Published 07/10/2007
3-30 Benefits Cost Worksheet Human Resources Published 10/07/2010
3-30 Benefits Cost Worksheet Human Resources Published 07/10/2007
3-31 Dependent Enrollment and Status Change Form Human Resources Discontinued 08/13/2010
3-31 Dependent Enrollment and Status Change Form Human Resources Published 07/10/2007
3-32 UTFLEX Enrollment Form Human Resources Discontinued 08/13/2010
3-32 UTFLEX Enrollment Form Human Resources Published 07/10/2007
3-33 Coverage for Incapacitated Child Form Human Resources Published 07/10/2007
3-34 Medco Pharmacy Home Delivery Order Form (UT Select) Human Resources Published 07/10/2007
3-35 Medco Prescription Drug Claim Form (UT Select) Human Resources Published 07/10/2007
3-36 Transitional Benefits Form Human Resources Published 07/10/2007
3-37 UT Select Dental Claim Form Human Resources Published 07/10/2007
3-38 Superior Vision Provider Nomination Human Resources Published 07/10/2007
3-39 UT FLEX Claim Form Human Resources Published 07/10/2007
3-40 UT FLEX Direct Deposit Form Human Resources Published 07/10/2007
3-41 UT FLEX Letter of Medical Necessity Human Resources Published 07/10/2007
3-42 Fort Dearborn Term Life Beneficiary Designation Human Resources Published 07/10/2007
3-43 Optional Retirement Program (ORP) Retirement Certification Form Human Resources Discontinued 03/18/2008
3-44 Notice of Creditable Coverage for Medicare Part D Human Resources Published 07/10/2007
3-45 TRS Form 6 (Notice of Final Deposit and Request for Refund) Human Resources Published 07/10/2007
3-46 TRS Form 18 (Request for Estimate of Retirement Benefits) Human Resources Published 07/10/2007
3-47 Transfer Verification Form Human Resources Published 07/10/2007
3-48 TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program) Human Resources Published 07/10/2007
3-49 TRS Form 29 (Application for Refund) Human Resources Published 07/10/2007
3-50 Authorization for Reduction for Employee Contributions Human Resources Published 07/10/2007
3-51 Authorization for Reduction for Employee Contributions for Employees returning to ORP Human Resources Published 07/10/2007
3-52 ORP Acknowledgement Form Human Resources Published 07/10/2007
3-53 Optional Retirement Program (ORP) Retirement Certification Form Human Resources Published 07/10/2007
3-54 Tax-Sheltered Annuity Disclosure Human Resources Published 07/10/2007
3-55 Purchase Change Agreement Human Resources Published 07/10/2007
3-56 Special Catch-Up Provision Disclosure Human Resources Published 07/10/2007
3-57 Short Term Disability Highlights Human Resources Published 01/07/2010
3-57 Short Term Disability Frequently Asked Questions Human Resources Published 07/10/2007
3-58 Long Term Care Brochure Human Resources Published 07/10/2007
3-59 COBRA Continuation Notice Human Resources Published 07/10/2007
3-60 HIPAA Privacy Information Human Resources Published 07/10/2007
3-61 Accidental Death and Dismemberment Benefits Guide Human Resources Published 07/10/2007
3-62 Assurant Dental HMO Benefits Guide Human Resources Published 07/10/2007
3-63 UT System Group Benefit Handbook for Employees Human Resources Published 10/07/2010
3-63 UT System Group Benefit Handbook for Employees Human Resources Published 07/10/2007
3-64 Group Term Life Benefits Guide Human Resources Published 07/10/2007
3-65 Employee Discount Program Participation Agreement Human Resources Discontinued 08/20/2009
3-65 Employee Discount Program Participation Agreement Human Resources Published 04/10/2008
3-66 Long Term Disability Benefits Guide Human Resources Published 07/10/2007
3-67 Short Term Disability Benefits Guide Human Resources Published 07/10/2007
3-67 Short Term Disability Benefits Guide Human Resources Published 07/10/2007
3-68 Superior Vision Benefits Guide Human Resources Published 07/10/2007
3-69 Teachers Retirement System (TRS) Handbook Human Resources Published 07/10/2007
3-70 UT FLEX Benefits Guide Human Resources Published 07/10/2007
3-71 UT Select Benefits Guide Human Resources Published 07/10/2007
3-72 UT Select Dental Benefits Guide Human Resources Published 07/10/2007
3-73 UT System Group Benefits Handbook for Retirees Human Resources Published 10/07/2010
3-73 UT System Group Benefits Handbook for Retirees Human Resources Published 07/10/2007
3-74 UT System Retirement Programs Guide Human Resources Published 07/10/2007
3-75 Exit Interview Questionnaire Human Resources Published 07/28/2010
3-75 Exit Interview Questionnaire Human Resources Published 02/15/2010
3-76 Quest Release Time Form Human Resources Published 05/10/2008
3-77 Employee Tuition Certification Form Human Resources Published 07/24/2008
3-79 Employee Self-Evaluation Form Human Resources Published 01/21/2011
3-80 Administrative and Professional Form Human Resources Published 01/21/2011
3-81 Classified Staff Evaluation Form - Check Box Format Human Resources Published 01/21/2011
3-84 Sample Reference Check Form Human Resources Published 03/23/2009
3-85 On-Campus Summer Camp / Conference Employment Application Human Resources Published 10/12/2011
3-85 On-Campus Summer Camp / Conference Employment Application Human Resources Discontinued 05/25/2011
3-85 On-Campus Summer Camp / Conference Employment Application Human Resources Published 04/01/2009
3-86 Flexible Work Arrangement Agreement Human Resources Published 02/12/2010
3-87 Telecommuting Agreement Human Resources Published 02/12/2010
3-201 Personal Information Form Human Resources Published 07/16/2007
3-202 State Employment Verification Form Human Resources Published 03/04/2008
3-203 Selective Service Registration Verification Form Human Resources Published 03/04/2008
3-204 Sick Leave Pool Contribution Form Human Resources Published 11/11/2009
3-205 Financial Disclosure and Conflicts of Interest Human Resources Published 04/26/2010
3-206 Outstanding Maverick Award Nomination Form Human Resources Published 10/19/2011
3-206 Outstanding Maverick Award Nomination Form Human Resources Published 09/28/2011
3-206 Outstanding Maverick Award Nomination Form Human Resources Published 10/29/2010
4-1 Request to Purchase - Standard Request Procurement Published 08/31/1999
4-2 Request to Purchase - Split Accounts Procurement Published 08/31/1999
4-3 Request to Purchase - Confirmation Request Procurement Published 08/31/1999
4-4 Purchasing Card Reconciliation Log and Example Procurement Published 08/31/1999
4-5 Purchasing Card Transaction Log and Example Procurement Published 08/31/1999
4-6 Asset Information Form Procurement Discontinued 05/06/2008
4-7 Statement of Disputed Item Form ( ProCard) Procurement Discontinued 08/31/1999
4-8 Purchasing Card Application Procurement Published 08/31/1999
4-9 Wireless Communication Device Allowance Request Procurement Published 06/08/2004
4-9 Tax Exemption Certificate Procurement Discontinued 08/31/1999
4-10 Vendor Performance Form Procurement Published 08/31/1999
4-11 Cardholder Agreement Procurement Published 08/31/1999
4-12 Major Consulting Services Contract Approval Request Procurement Discontinued 12/16/2011
4-12 Major Consulting Services Contract Approval Request Procurement Published 11/18/2004
4-12 Letter of Written Justification for a Single Source Procurement Procurement Discontinued 08/31/1999
4-13 Emergency Justification Procurement Published 11/30/2001
4-14 Sole-Source/Proprietary Justification For Services Procurement Published 11/30/2001
4-15 Sole-Source/Proprietary Justification For Goods Procurement Published 11/30/2001
4-16 Gift Certificate Expense Form Procurement Published 06/14/2007
4-17 Comdata Corporation Dispute Processing Form Procurement Published 07/18/2007
4-18 Summus/Staples Application Procurement Published 06/18/2007
4-20 Vendor Direct Deposit / Advance Payment Notification Authorization Procurement Published 02/14/2011
5-1 Notice to Department - Automotive Preventative Maintenance Schedule Facilities Discontinued 08/31/1999
5-2 2nd Notice to Department - Automotive Preventative Maintenance Schedule Facilities Discontinued 08/31/1999
5-3 Sample Interdepartmental Transfer for Vehicle Repair Facilities Discontinued 08/31/1999
5-4 Vehicle Request Form Facilities Published 12/08/2004
5-5 Operation of UTA 15-Passenger Vans Facilities Published 12/08/2004
6-1 GTA Parking Permit Decal Permission Police Published 07/25/2006
6-1 Key Return/Receipt Police Discontinued 08/31/1999
6-2 Special Parking Permit/Salary Verification Police Discontinued 06/15/2007
6-2 Key Control Department/Payment for Lost Keys Police Discontinued 08/31/1999
6-3 Key Request Police Published 08/30/2011
6-3 Key Request Police Published 09/16/2010
6-3 Key Request Issuance and Receipt Police Discontinued 08/31/1999
6-4 Lost or Missing University Report Form Police Published 08/24/2011
6-4 Lost or Missing University Report Form Police Published 02/25/2011
6-5 Lost Property Report Form Police Published 02/25/2011
7-1 Request to Host a Camp/Conference Conference Services Published 05/03/2011
7-2 Facility Insurance Agreement Conference Services Published 05/03/2011
7-3 Summer Conference Housing Reservation Request Conference Services Published 05/03/2011
7-4 Summer Conference Dining Request Conference Services Published 05/03/2011
7-5 Admissions Tours and Presentation Request Conference Services Published 05/03/2011
7-6 Conference Services IDT Form Conference Services Published 07/12/2011
7-7 Consent to Obtain Medical Treatment for Minor Child Conference Services Published 07/12/2011
7-8 Advance Planning (Cosmic) Calendar Reservation Request E.H. Hereford University Center Published 08/19/2011
7-9 Department Event Request E.H. Hereford University Center Published 08/19/2011
8-1 Instructions for Employers First Report of Injury or Illness EH&S - WCI Discontinued 06/01/2000
8-2 Supervisor's Report of Employee Work-Related Injury or Occupational Disease EH&S - WCI Published 10/24/2007
8-2 Employers First Report of Injury or Illness EH&S - WCI Discontinued 06/01/2000
8-3 Supplemental Report of Injury EH&S - WCI Published 06/24/2008
8-3 Supplemental Report of Injury EH&S - WCI Discontinued 02/28/2008
8-3A Supplemental Report of Injury EH&S - WCI Discontinued 06/01/2000
8-3 Instructions for TWCC-6 (Supplemental Report of Injury) EH&S - WCI Discontinued 06/01/2000
8-4 Request for Paid Leave Due to On-The-Job Injury EH&S - WCI Published 06/01/2000
8-5 Employer's Wage Statement EH&S - WCI Discontinued 02/28/2008
8-6 Employee's Report of Work-Related Injury or Occupational Disease EH&S - WCI Published 06/01/2000
8-7 Detailed Description of Injury/Illness and Accident Scene EH&S - WCI Discontinued 11/02/2007
8-8 Modified Work Duty Agreement EH&S - WCI Discontinued 06/01/2000
8-9 Notification of Work-Related Injury EH&S - WCI Published 12/08/2004
8-9 Return to Work Certification EH&S - WCI Discontinued 06/01/2000
8-10 Injured Employee Workers Compensation Guidelines EH&S - WCI Published 04/14/2005
8-11 Supervisor's Workers Compensation Checklist EH&S - WCI Published 04/14/2005
8-12 Workers Compensation Injury Witness Statement EH&S - WCI Published 02/21/2005
8-13 Ergonomic Evaluation Request EH&S - WCI Published 08/10/2006
8-14 myMatrixx First Fill Pharmacy Card EH&S - WCI Published 01/29/2010
8-14 HSI Rx First Fill Pharmacy Card EH&S - WCI Discontinued 09/01/2009
8-14 Bridgeway First Fill Pharmacy Card EH&S - WCI Published 01/30/2008
8-15 Work Status Report and Instructions EH&S - WCI Published 02/01/2011
8-15 Work Status Report and Instructions EH&S - WCI Published 02/28/2008
8-16 Workers Compensation Insurance Employee Request for Reimbursement of Medical Expenses EH&S - WCI Published 06/24/2008
8-17 Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease EH&S - WCI Published 06/24/2008
8-18 Notice of Fatal Injury or Occupational Disease and Claim for Compensation for Death Benefits EH&S - WCI Published 06/24/2008
8-19 Employee's Request to Change Treating Doctor - Non Network EH&S - WCI Published 06/24/2008
8-26 Biosafety Lab Evaluation Form EH&S - Biological Published 08/01/2005
8-27 Survey of Biological Agents Form EH&S - Biological Discontinued 11/06/2009
8-27 Survey of Biological Agents Form EH&S - Biological Published 08/01/2005
8-28 Request for Disposal Form - Biological Waste and Sharps EH&S - Biological Published 08/01/2005
8-29 Hepatitis B Vaccine Waiver EH&S - Biological Published 05/21/2008
8-30 Human Pathogen Registration Document EH&S - Biological Published 05/21/2008
8-31 Human Pathogen Registration Update EH&S - Biological Published 05/21/2008
8-32 Vaccinia Declination Form EH&S - Biological Published 08/22/2011
8-33 Autoclave Waste Treatment Log EH&S - Biological Published 11/02/2011
8-36 Laboratory Safety Evaluation Checklist EH&S - Chemical Published 09/09/2005
8-37 Request for Disposal - Hazardous Chemicals EH&S - Chemical Discontinued 12/06/2011
8-37 Request for Disposal - Hazardous Chemicals EH&S - Chemical Published 09/09/2005
8-46 UTA Hazard Reporting Form EH&S - DSL Published 10/05/2005
8-56 Application for Copy of Driver Record EH&S - Driving Published 08/10/2005
8-61 UTA Hot Work Permit EH&S - Fire Published 09/08/2005
8-62 Charcoal and Propane Grill Permit EH&S - Fire Published 10/31/2011
8-66 Lockout/Tagout Authorized Employee Training Form EH&S - Occupational Published 03/13/2006
8-67 Lockout/Tagout Request Form EH&S - Occupational Published 03/13/2006
8-68 Lockout/Tagout Master Index Form EH&S - Occupational Published 03/13/2006
8-69 Lockout/Tagout Periodic Inspection Form EH&S - Occupational Published 03/13/2006
8-70 First Aid Kit Supply Request Form EH&S - Occupational Published 03/13/2006
8-71 IAQ Occupant Interview Form EH&S - Occupational Published 03/13/2006
8-72 Student Visitor Injury-Illness Form EH&S - Occupational Published 10/18/2007
8-73 Confined Spaces Entry Plan EH&S - Occupational Published 08/29/2011
8-74 Confined Spaces Inventory Form EH&S - Occupational Published 08/29/2011
8-81 Application to Use Radioactive Materials EH&S - Radiation Published 08/17/2005
8-82 Request for Radiation Dosimeter Form EH&S - Radiation Published 08/17/2005
8-83 Request to Purchase Radioactive Materials Form EH&S - Radiation Published 08/18/2005
8-84A Radiation Safety Evaluation - Radioactive Materials EH&S - Radiation Published 08/18/2005
8-84B Radiation Safety Evaluation - X-Ray Producing Machines EH&S - Radiation Published 08/18/2005
8-84C Radiation Safety Evaluation - Lasers EH&S - Radiation Published 08/18/2005
8-85 Pregnancy Declaration EH&S - Radiation Published 02/15/2008
8-86 Pregnancy Declaration Withdrawal EH&S - Radiation Published 02/15/2008
8-87 Biosafety Level 2 (BSL-2) Commissioning Checklist EH&S - Biological Published 02/09/2009
8-88 Laser Registration Form EH&S - Radiation Published 03/10/2009
9-1A Report of Medical History and Health Evaluation Health Services Published 09/20/2011
9-1A Report of Medical History and Health Evaluation Health Services Published 07/07/2011
9-1 Description of a Large System Development Project Office of Information Technology Discontinued 08/31/1990
9-2 Financial Policy Health Services Published 06/28/2011
9-2 Request for Administrative Information Systems Services Office of Information Technology Discontinued 08/31/1990
9-3 Authorization to Treat Minors Health Services Published 07/11/2011
9-3 Computer Configuration in Administrative Information Systems Office of Information Technology Discontinued 08/31/1990
9-4 Consent for Treatment of a Minor Who Does Not Have Legal Power to Consent Health Services Published 06/28/2011
9-5 Notice of Privacy Practices (Short Version) Health Services Discontinued 09/14/2011
9-5 Notice of Privacy Practices (Short Version) Health Services Published 06/08/2010
9-6 Notice of Privacy Practices (Long Version) Health Services Discontinued 09/14/2011
9-6 Notice of Privacy Practices (Long Version) Health Services Published 06/08/2010
9-7 Authorization for the Use and Disclosure of Protected Health Information Health Services Published 06/06/2011
9-8 Request and Authorization for Release of Student Medical Information Health Services Discontinued 06/30/2011
9-8 Request and Authorization for Release of Student Medical Information Health Services Published 06/06/2011
11-1 Paper Order Request Maverick Print Discontinued 06/24/2011
11-1 Paper Order Form Maverick Print Published 12/08/2004
11-1 Printing Trade Customs Maverick Print Discontinued 08/31/1984
11-2 Forms Order Request Maverick Print Discontinued 06/24/2011
11-2 Forms Order Request Maverick Print Published 12/08/2004
11-2 Printing Order Form Maverick Print Discontinued 08/31/1984
11-3 Print Order Request Maverick Print Discontinued 06/24/2011
11-3 Print Order Form Maverick Print Published 12/08/2004
11-5 Print Proof Form Maverick Print Discontinued 05/06/2008
12-1 Guest Apartment Reservation Request Guest Apartments Published 09/01/2011
13-1 Faculty and Staff Organization Registration Form Administration and Campus Operations Published 12/08/2004
13-1 Affidavit for Faculty and Staff Organizations Administration and Campus Operations Discontinued 10/01/1991
13-2 Records Retention Log Business Affairs and Controller Discontinued 02/04/2009
13-2 Records Retention Log Business Affairs and Controller Published 12/08/2004
13-2 Faculty and Staff Organization Registration Form Business Affairs and Controller Discontinued 10/01/1991
13-4 Procedure Template Business Affairs and Controller Published 07/09/2010
13-4 Forms and Exhibits Template Business Affairs and Controller Discontinued 07/09/2010
13-4 Fiscal Procedure Exhibit Template Business Affairs and Controller Published 10/26/2007
13-5 Forms and Exhibits Template Business Affairs and Controller Published 01/27/2011
13-5 Forms and Exhibits Template Business Affairs and Controller Published 07/09/2010
13-6 Records Disposition Log Records and Information Management Published 02/04/2009
13-7 Request for Authority to Dispose of Unscheduled University Records Records and Information Management Published 02/04/2009
13-9 Preliminary Summary Report of Tort Claims and Possible Tort Claims Business Affairs and Controller Published 08/25/2009
13-10 Records Retention Recertification and Survey Records and Information Management Published 03/08/2011
14-1 Photographic Consent and Release Form General Published 08/24/2011
15-1 Summer Conference Statement on Insurance Conferences Services Discontinued 05/03/2011
15-1 Summer Conference Statement on Insurance Conferences Services Published 03/27/2005
15-2 Summer Conference Admission Presentation Request Form Conferences Services Discontinued 05/03/2011
15-2 Summer Conference Admission Presentation Request Form Conferences Services Published 03/27/2005
15-3 Summer Conference Access Card & Hang Tag Form Conferences Services Discontinued 05/06/2008
15-4 Summer Conference Housing Reservation Form Conferences Services Discontinued 05/03/2011
15-4 Summer Conference Housing Reservation Form Conferences Services Published 03/27/2005
15-5 Summer Conference Dining Reservation Form Conferences Services Discontinued 05/03/2011
15-5 Summer Conference Dining Reservation Form Conferences Services Published 03/27/2005
15-6 Summer Conference E.H. Hereford University Center Facility Reservation Form Conferences Services Discontinued 07/12/2011
15-6 Summer Conference E.H. Hereford University Center Facility Reservation Form Conferences Services Published 03/27/2005
15-7 Summer Conference Activities Building Rental Application Conferences Services Discontinued 05/03/2011
15-7 Summer Conference Activities Building Rental Application Conferences Services Published 03/27/2005
15-8 Summer Conference Texas Hall Reservation Request Conferences Services Discontinued 05/06/2008
15-9 Summer Conference Housing Equipment Issuance Authorization Conferences Services Discontinued 05/03/2011
15-9 Summer Conference Housing Equipment Issuance Authorization Conferences Services Published 05/27/2008
15-10 Alcoholic Beverage Request Form Dining Services Published 10/04/2010
15-10 Alcoholic Beverage Request Form Dining Services Published 12/04/2008
15-13 Release and Indemnification Agreement for Minors Administration and Campus Operations Published 08/06/2010
15-13 Release and Indemnification Agreement for Minors Administration and Campus Operations Published 05/25/2010
15-13 Release and Indemnification Agreement for Minors Conferences Services Published 04/01/2010
15-13 Release and Indemnification Agreement for Minors Administration and Campus Operations Published 04/01/2010
15-14 Photographic Consent and Release Conferences Services Discontinued 05/03/2011
15-14 Photographic Consent and Release Conferences Services Published 04/01/2010
15-15 Release and Indemnification Agreement for Adult Students Administration and Campus Operations Published 08/06/2010
15-15 Release and Indemnification Agreement for Adult Students Administration and Campus Operations Published 05/25/2010
15-16 Release and Indemnification Agreement for Adults Administration and Campus Operations Published 08/06/2010
15-16 Release and Indemnification Agreement for Adults Administration and Campus Operations Published 05/25/2010
15-17 Food Waiver Request Application Dining Services Published 08/03/2011
18-1 Encryption Exception Form Information Security Office Published 08/26/2011
19-1 Server Hosting Service Level Agreement Office of Information Technology Published 09/13/2011
20-1 UTA Gift Records Form Accounting/Development Published 12/08/2004
20-2 UTA Payroll Gift Deduction Form Payroll/Development Published 06/07/2005
21-1 Request for Disbursement of Scholarship/Fellowship Award Scholarships Published 01/12/2011
21-1 Request for Disbursement of Scholarship/Fellowship Award Scholarships Published 06/09/2010
21-1 Request for Disbursement of Scholarship/Fellowship Award Accounting/Financial Aid Published 12/16/2005
21-2 Scholarship Committee Chair Scholarships Published 06/09/2010
22-4 Departmental Request to Initiate Legal Permanent Resident Equal Opportunity Services Published 07/23/2009
24-1 Policy Template Format Guidelines President's Office Published 01/15/2010
25-1 Procedure Template Business Affairs Discontinued 07/09/2010
25-1 Procedure Template Business Affairs Published 06/16/2010